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Profile of MicroRNAs Associated with Death Due to Disease Progression in Metastatic Papillary Thyroid Carcinoma Patients. Cancers (Basel) 2023; 15:cancers15030869. [PMID: 36765828 PMCID: PMC9913691 DOI: 10.3390/cancers15030869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Papillary thyroid carcinoma (PTC) is the most common neoplasm of the endocrine system and has an excellent long-term prognosis, with low rates of distant metastatic disease. Although infrequent, there are cases of deaths directly related to PTC, especially in patients with metastatic disease, and the factors that could be associated with this unfavorable outcome remain a major challenge in clinical practice. Recently, research into genetic factors associated with PTC has gained ground, especially mutations in the TERT promoter and BRAF gene. However, the role of microRNAs remains poorly studied, especially in those patients who have an unfavorable outcome at follow-up. This paper aims to evaluate molecular markers related to the different pathological processes of PTC, as well as the histological characteristics of the neoplasm, and to compare this profile with prognosis and death from the disease using an analysis of patients treated for metastatic disease in a single tertiary cancer center. Evaluation of microRNA expression in paraffin-embedded tumor specimens was carried out by quantitative PCR using the TaqMan® Low Density Array (TLDA) system. Metastatic patients who died from progression of PTC had higher expressions of miR-101-3p, miR-17-5p, and miR-191-5p when compared to patients with stable metastatic disease. These findings are of great importance but should be considered as preliminary because of the small sample.
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Swan KZ, Nielsen VE, Bonnema SJ. Evaluation of thyroid nodules by shear wave elastography: a review of current knowledge. J Endocrinol Invest 2021; 44:2043-2056. [PMID: 33864241 DOI: 10.1007/s40618-021-01570-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 04/04/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Shear wave elastography (SWE), as a tool for diagnosing thyroid malignancy, has gathered considerable attention during the past decade. Diverging results exist regarding the diagnostic performance of thyroid SWE. METHODS A comprehensive literature review of thyroid SWE was conducted using the terms "Thyroid" and "shear wave elastography" in PubMed. RESULTS The majority of studies found SWE promising for differentiating malignant and benign thyroid nodules on a group level, whereas results are less convincing on the individual level due to huge overlap in elasticity indices. Further, there is lack of consensus on the optimum outcome reflecting nodule elasticity and the cut-off point predicting thyroid malignancy. While heterogeneity between studies hinders a clinically meaningful meta-analysis, the results are discussed in a clinical perspective with regard to applicability in clinical practice as well as methodological advantages and pitfalls of this technology. CONCLUSION Technological as well as biological hindrances seem to exist for SWE to be clinically reliable in assessing benign and malignant thyroid nodules. Structural heterogeneity of thyroid nodules in combination with operator-dependent factors such as pre-compression and selection of scanning plane are likely explanations for these findings. Standardization and consensus on the SWE acquisition process applied in future studies are needed for SWE to be considered a clinically reliable diagnostic tool for detection of thyroid cancer.
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Affiliation(s)
- K Z Swan
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark.
- Department of Clinical Medicine, Faculty of Health, Aarhus University , Aarhus, Denmark.
| | - V E Nielsen
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Odense University Hospital, Odense, Denmark
| | - S J Bonnema
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
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Dinauer CA. Malignancy Rates in Cytologically Indeterminate Thyroid Nodules among Children Are Lower Than Previously Reported but Remain Higher Than in Adults. ACTA ACUST UNITED AC 2019. [DOI: 10.1089/ct.2019;31.158-161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Catherine A. Dinauer
- Yale Pediatric Thyroid Center, Division of Pediatric Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, U.S.A
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Koh J, Moon HJ, Kim EK, Kwak JY, Yoon JH. The 5-tiered categorization system for reporting cytology is sufficient for management of patients with thyroid nodules compared to the 6-tiered Bethesda system. Endocrine 2016; 53:489-96. [PMID: 26758996 DOI: 10.1007/s12020-015-0854-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 12/30/2015] [Indexed: 02/07/2023]
Abstract
To analyze whether the 5-tiered categorization system without the atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) category is sufficient compared to the 6-tiered Bethesda system. This IRB-approved retrospective study was waived informed consent. The pre-Bethesda period was from March 2008 to December 2008 and the Bethesda period was from January 2012 to January 2013. Of 4677 nodules ≥10 mm with initial ultrasonography-guided fine-needle aspiration, 2553 nodules were from the pre-Bethesda period and 1754 nodules were from the Bethesda period. The utilization and malignancy rates of each category were compared between the two periods. The utilization rate of the benign category decreased from 67.7 % in the pre-Bethesda period to 60.0 % in the Bethesda period (p = 0.001). In the pre-Bethesda period, the malignancy rates of the non-diagnostic, benign, suspicious follicular neoplasm/Hürthle cell neoplasm, suspicious for malignancy, and malignancy categories were 3.8, 1.9, 25, 78.8, and 99.7 %, respectively. The malignancy rate of the benign category decreased from 1.9 to 0.3 % after the Bethesda system (p < 0.001). The utilization and malignancy rates of the AUS/FLUS category were 7 and 22.8 %. When the AUS/FLUS category was included in the benign category, the malignancy rate became 2.6 % which was not significantly different from 1.9 % in the pre-Bethesda period (p = 0.189). The malignancy rates of other categories were not significantly different. The 5-tiered categorization system without the AUS/FLUS category for reporting cytology was sufficient for management of patients with thyroid nodules compared to the 6-tiered categorization of the Bethesda system.
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Affiliation(s)
- Jieun Koh
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Hee Jung Moon
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
| | - Eun-Kyung Kim
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Jin Young Kwak
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Jung Hyun Yoon
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
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Canberk S, Gunes P, Onenerk M, Erkan M, Kilinc E, Kocak Gursan N, Kilicoglu GZ. New Concept of the Encapsulated Follicular Variant of Papillary Thyroid Carcinoma and Its Impact on the Bethesda System for Reporting Thyroid Cytopathology: A Single-Institute Experience. Acta Cytol 2016; 60:198-204. [PMID: 27414983 DOI: 10.1159/000447990] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 06/23/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND The encapsulated follicular variant (EFV) of papillary thyroid carcinoma (PTC) is the most discussed entity in thyroid pathology. Recently, the question of whether or not EFV-PTC is a malignant entity has been the subject of renewed discussion in the light of recent molecular and clinical studies. The aim of this study was to analyze the malignancy ratios of each category of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) if EFV-PTC is no longer considered as a malignant entity. MATERIALS AND METHODS Data on thyroid fine-needle aspirations (n = 1,886) with surgical follow-up between 1999 and 2014 were studied. EFV-PTC cases constituted 27% (94/343) of the malignant cases. RESULTS Malignancy ratios were determined as nondiagnostic, benign, atypia/follicular lesion of undetermined significance, suspicious for follicular neoplasm/follicular neoplasm, suspicious for malignancy, and malignant categories of the TBSRTC in 13, 7, 45, 30, 72 and 98%, respectively. If EFV-PTC was not regarded as malignant, malignancy ratios would decrease to 6.5, 6, 30, 10, 48, and 87% for each category in the same order. CONCLUSIONS The current study showed that the most significant decrease in relative malignancy ratios was seen in the suspicious for follicular neoplasm/follicular neoplasm category (66% relative decrease), but all categories represented a considerable decrease.
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Affiliation(s)
- Sule Canberk
- Department of Pathology-Cytopathology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
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Amirazodi E, Propst EJ, Chung CT, Parra DA, Wasserman JD. Pediatric thyroid FNA biopsy: Outcomes and impact on management over 24 years at a tertiary care center. Cancer Cytopathol 2016; 124:801-810. [DOI: 10.1002/cncy.21750] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/07/2016] [Accepted: 04/07/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Elmira Amirazodi
- Division of Endocrinology; The Hospital for Sick Children; Toronto Ontario Canada
| | - Evan J. Propst
- Department of Otolaryngology, Head and Neck Surgery; The Hospital for Sick Children and University of Toronto; Toronto Ontario Canada
| | - Catherine T. Chung
- Division of Pathology; The Hospital for Sick Children; Toronto Ontario Canada
| | - Dimitri A. Parra
- Department of Diagnostic Imaging; The Hospital for Sick Children; Toronto Ontario Canada
| | - Jonathan D. Wasserman
- Division of Endocrinology; The Hospital for Sick Children; Toronto Ontario Canada
- Department of Pediatrics; University of Toronto; Toronto Ontario Canada
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Melo-Uribe MA, Sanabria Á, Romero-Rojas A, Pérez G, Vargas EJ, Abaúnza MC, Gutiérrez V. The Bethesda system for reporting thyroid cytopathology in Colombia: Correlation with histopathological diagnoses in oncology and non-oncology institutions. J Cytol 2015; 32:12-6. [PMID: 25948937 PMCID: PMC4408670 DOI: 10.4103/0970-9371.155224] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim: To determine the correlation between the results of thyroid fine-needle aspirations interpreted using the Bethesda system and final histopathological reports for patients at an oncology hospital (OH) and non-oncology hospitals (NOHs). Materials and Methods: A retrospective, cross-sectional, descriptive study was performed to compare the cytology and histopathology results for patients with thyroid nodules in three Colombian hospitals. The final correlation of diagnoses between the two methods is reported. In Colombia, the health system provides the existence of general care hospitals and hospitals specializing in care of patients with cancer. Results: A total of 196 reports were reviewed, of which 53% were from OH and 47% were from NOHs. A greater proportion of category V (37.5%) was diagnosed at the OH, whereas NOHs diagnosed a greater proportion of category II (42.3%). The global correlation between diagnoses made using cytology and histopathology was 93.3% for categories V and VI (based on the final malignant diagnosis) and 86.9% for benign category II. Significant differences between institution types were observed when category IV and V and malignant histopathology were compared (56.3% OH vs. 23.5% NOH; P = 0.05 for category IV, 97.4% OH vs. 82.3% NOH; P = 0.03 for category V), while no significant difference between institution types was observed when category II and final benign diagnosis were compared (P = 0.6). Conclusions: The Bethesda system for thyroid cytology correlates adequately with final histopathological diagnosis in Colombia. Significant differences were identified in the diagnostic correlation for malignant lesions between the OH and NOHs in categories IV and V caused by selection bias of the population.
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Affiliation(s)
| | - Álvaro Sanabria
- Department of Surgery, Universidad de Antioquia-Hospital Pablo Tobón Uribe, Colombia
| | | | - Gabriel Pérez
- Department of Pathology, Universidad Industrial de Santander, Colombia
| | | | | | - Víctor Gutiérrez
- Department of Pathology, Hospital Central de la Policía Nacional, Colombia
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Abstract
Two promoter mutations, chr5:1 295 228C>T and chr5:1 295 250C>T, in the gene for telomerase reverse transcriptase (TERT) have been recently identified in thyroid cancers and shown to be important in thyroid tumor pathogenesis. The diagnostic and prognostic potentials of testing for these mutations on thyroid fine-needle aspiration biopsy (FNAB) have not been investigated. Herein, we examined the two TERT promoter mutations along with the BRAF V600E mutation by direct DNA sequencing on 308 FNAB specimens preoperatively obtained from thyroid nodules with postoperatively confirmed pathological diagnoses. We found TERT promoter mutations in 0.0% (0/179) of benign thyroid nodules and 7.0% (9/129) of thyroid nodules of differentiated thyroid cancer, representing a 100% diagnostic specificity and 7.0% sensitivity, with the latter rising to 38.0% (49/129) when combined with BRAF V600E testing. Several TERT-promoter-mutation-positive thyroid nodules were cytologically indeterminate on FNAB. Approximately 80% of the TERT promoter mutation-positive thyroid nodules were thyroid cancers with aggressive clinicopathological behaviors, such as extrathyroidal invasion, lymph node metastases, distant metastases, disease recurrence or patient death. Thus, a positive TERT promoter mutation test not only definitively diagnoses a thyroid nodule as cancerous but also preoperatively identifies a cancer with aggressive potential. This is the first study, to our knowledge, of TERT promoter mutations on thyroid FNAB, demonstrating the value of this novel molecular testing in the diagnosis of thyroid nodules and preoperative risk stratification of thyroid cancer. Thus, testing of TERT promoter mutations on FNAB will enhance and improve the current molecular-based approaches to the management of thyroid nodules and thyroid cancer.
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Affiliation(s)
- Rengyun Liu
- Laboratory for Cellular and Molecular Thyroid ResearchDivision of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, Maryland 21287, USA
| | - Mingzhao Xing
- Laboratory for Cellular and Molecular Thyroid ResearchDivision of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, Maryland 21287, USA
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Sheffield BS, Masoudi H, Walker B, Wiseman SM. Preoperative diagnosis of thyroid nodules using the Bethesda System for Reporting Thyroid Cytopathology: a comprehensive review and meta-analysis. Expert Rev Endocrinol Metab 2014; 9:97-110. [PMID: 30743753 DOI: 10.1586/17446651.2014.887435] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Fine-needle aspiration biopsy (FNAB) is the test of choice for the evaluation of nodules, arriving at a cancer diagnosis, and guiding surgical management. This review and meta-analysis aims to objectively evaluate the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) based upon literature reports of histopathological outcomes following cytopathological diagnoses. Thirteen studies were reviewed and the risk of malignancy (ROM) for each of the BSRTC diagnostic categories were calculated as: Non-diagnostic 11-26%, Benign 4-9%, AUS/FLUS 19-38%, FN/SFN 27-40%, SFM 50-79%, and Malignant 98-100%. In typical clinical utilization, the sensitivity and specificity of thyroid FNAB diagnosis using the BSRTC were 96% and 46%, respectively. The BSRTC represents an important advance in standardizing thyroid FNAB cytopathological reporting. Close attention should be paid to the observation that the AUS-FLUS and FN-SFN DCs have overlapping ROMs, and the potential clinical implications of this finding on patient management.
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Affiliation(s)
- Brandon S Sheffield
- a Department of Pathology and Laboratory Medicine, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Hamid Masoudi
- a Department of Pathology and Laboratory Medicine, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Blair Walker
- a Department of Pathology and Laboratory Medicine, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Sam M Wiseman
- b Department of Surgery, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
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Boufraqech M, Patel D, Xiong Y, Kebebew E. Diagnosis of thyroid cancer: state of art. ACTA ACUST UNITED AC 2013; 7:331-42. [PMID: 23701167 DOI: 10.1517/17530059.2013.800481] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Thyroid cancer is the most common endocrine cancer in the USA and its incidence is increasing worldwide. Thyroid fine-needle aspiration biopsy (FNA) and cytologic analysis is the most cost-effective approach to distinguish between malignant and benign thyroid nodules. However, up to 30% of thyroid FNA biopsy results are inconclusive. AREAS COVERED In this article, the authors provide an update on the current status and emerging approaches for improving thyroid cancer diagnosis. This review covers imaging, genetic and genomic approaches being used or in development to help distinguish between malignant and benign thyroid nodules. EXPERT OPINION There has been considerable progress in improving thyroid cancer diagnosis. The molecular markers analysis to avoid diagnostic surgeries seems to be promising. However, the clinical utility and accuracy of some markers reported in this review are not conclusive and need to be validated as clinical diagnostic tool.
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Affiliation(s)
- Myriem Boufraqech
- National Cancer Institute, National Institutes of Health, Endocrine Oncology Branch, 10 Center Drive, Bethesda, MD 20892, USA
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Reis CF, Carneiro AP, Vieira CU, Fujimura PT, Morari EC, Silva SJD, Goulart LR, Ward LS. An antibody-like peptide that recognizes malignancy among thyroid nodules. Cancer Lett 2013; 335:306-13. [PMID: 23462224 DOI: 10.1016/j.canlet.2013.02.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 02/01/2013] [Accepted: 02/18/2013] [Indexed: 12/23/2022]
Abstract
There is an urgent need for biomarkers to identify malignant thyroid nodules from indeterminate follicular lesions. We have used a subtractive proteomic strategy to identify novel biomarkers by selecting ligands to goiter tissue from a 12-mer random peptide phage-displayed library using the BRASIL method (Biopanning and Rapid Analysis of Selective Interactive Ligands). After three rounds of selection, two highly reactive clones to the papillary thyroid tumor cell line NPA were further evaluated, and their specific binding to tumor proteins was confirmed using phage-ELISA. The antibody-like peptide CaT12 was tumor-specific, which was further tested by immunohistochemistry against TMAs (tissue microarrays) comprised of 775 human benign and malignant tissues, including 232 thyroid nodular lesions: 15 normal thyroid tissues, 53 nodular goiters (NG), 54 follicular adenomas (FA); 69 papillary thyroid carcinomas (PTC); and 41 follicular carcinomas (FC). CaT12 was able to identify PTC among thyroid nodular lesions with 91.2% sensitivity and 85.1% specificity, despite its non-specificity for thyroid tissues. Additionally, the CaT12 peptide helped characterize follicular lesions distinguishing the follicular variant of PTC (FVPTC) from FA with 91.9% accuracy; FVPTC from NG with 83.1% accuracy; FVPTC from the classic PTC with 57.7% accuracy; and FVPTC from FC with 88.7% accuracy. In conclusion, our strategy to select differentially expressed ligands to thyroid tissue was highly effective and resulted in a useful antibody-like biomarker that recognizes malignancy among thyroid nodules and may help distinguish follicular patterned lesions.
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Affiliation(s)
- Carolina Fernandes Reis
- Laboratory of Cancer Molecular Genetics, Faculty of Medical Sciences (FCM), University of Campinas (UNICAMP), Campinas, SP, Brazil
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Analysis of the bethesda system for reporting thyroid cytopathology and similar precursor thyroid cytopathology reporting schemes. Adv Anat Pathol 2012; 19:313-9. [PMID: 22885380 DOI: 10.1097/pap.0b013e3182666398] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Bethesda System for Reporting Thyroid Cytopathology is a standardized reporting system for classifying thyroid fine-needle aspiration results comprising of 6 diagnostic categories with unique risks of malignancy and recommendations for clinical management. The majority of thyroid nodules are benign; however, up to 30% of fine-needle aspiration of thyroid nodule results are equivocal. Until 2007, various diagnostic terms were used to classify such cases, including "atypical," "indeterminate," and rule-out or cannot exclude malignancy. A literature review of 13 original studies was conducted to evaluate whether utilization of the Bethesda System for Reporting Thyroid Cytopathology nomenclature represent an improvement over thyroid cytopathology reporting schemes used before 2007 in diagnosing thyroid malignancy. The sensitivity and specificity of thyroid fine-needle aspiration was high in the studies that assessed the measures. However, a selection bias exists and most studies do not include indeterminate diagnosis in their calculations. Although the Bethesda System for Reporting Thyroid Cytopathology recommends a repeat fine-needle aspiration to follow-up nondiagnostic specimens, in the majority of studies, an appreciable number of cases underwent follow-up surgical biopsy or thyroidectomy. The diagnostic category of atypia/follicular lesion of undetermined significance remains heterogenous in terms of usage and clinical outcome. The majority of the studies that utilize the Bethesda System for Reporting Thyroid Cytopathology in this literature review retrospectively reclassified thyroid fine-needle aspiration into the Bethesda System for Reporting Thyroid Cytopathology nomenclature with reported malignancy rates that are similar between cases reclassified as atypia/follicular lesion of undetermined significance and follicular neoplasm/suspicious for follicular neoplasm.
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